Posts Tagged ‘federalism’

Tim Dunlop breaks down some of the figures on federal-state proportional funding for hospitals:

In trying to untangle the rhetoric from both parties about their hospital policies the other day, one aspect I only touched on was the issue of funding. I noted that “the Federal Government…seems to be using the moment to decrease the amount of money they put into the system. The usual split between State and Commonwealth is 50/50, though under Mr Abbott the federal share has dropped to about 45%. The Health Minister is now talking in terms of a 40% Commonwealth share, at a time when costs are rising.”

Tim talks about the implications of this in terms of the Coalition’s new policy of forming local hospital boards, but it’s worth noting what this says about the historical situation. State governments (or, at the very least, some of them) have been increasing their spending on the health system in an attempt to improve one of the most vital services a government can provide. Meanwhile, the Commonwealth has allowed its investment in health to slip so that the states are shouldering more of the burden than ever before. Meanwhile, the federal Government happily attacks the states on two fronts: (i) they aren’t operating health services at an adequate level, and (ii) state governments running into debt are responsible for interest rate rises.

In other words, the Commonwealth keeps the money in their very deep pockets (all the better to fund advertising campaigns with), and they get to hit the states for both spending too much and not spending enough.

I’ll hold off on saying anything about whether Kevin Rudd’s proposed approach to managing the health system is good for health at this stage – like the AMA, I agree that more detail is needed (although I disagree that a Commonwealth health system is less capable of dealing with different needs around the country – as it is, state health systems are broken into regions, and a Commonwealth system can do the same).

I will say that politically it was a nice hit back – it gets headlines, shows a strategic vision, and it suggests a willingness to go up against the Premiers if need be (thus weakening Howard’s “wall-to-wall Labor” scare campaign) – but only after attempting a cooperative approach.

The next few days should be interesting, as the reactions start to play out and the Howard Central has to get a meaningful response together. Tony Abbott’s effort was just plain weak – he had to fight off the fact that he had floated something similar, and the “big echo” argument is preposterous. Proposing to take over the entire responsibility for the hospital system is entirely different from taking over a single hospital, which then needs to interface with the remainder of the health service which is still state-run. Howard’s approach was not a “test case”; it was a publicity stunt. And now it’s been overshadowed by a meaningful strategy – something Howard often struggles to come up with.

George Megalogenis points out Howard’s hypocrisy and Rudd’s shortcomings on the issue of federal-state roles and responsibilities.

The key point emerging from all of this posturing about hospitals (oops – I guess I should really use the singular), interest rates, schools, roads, etc. is that it’s tactical point-scoring without an emerging policy direction, on both sides of politics.

John and Kevin, here is your task: develop a clear model of Commonwealth-state relations, create policies that reflect it in a coherent manner, and campaign on them. If you’re not willing to do that, shut up about what’s wrong with the states or what’s wrong with how your opponent is treating the states.

Why does John Howard talk about the state governments with such obvious contempt? He conveys an expectation that everyone agrees that the states are being run badly and that we’ll all believe him when he says that all the problems with hospitals/schools/housing/inflation/etc. are their fault because we know they’re incompetent. Does he not realize that the voters he is speaking to are the same ones who elected those governments?

Given the consistent poll results showing a reasonably hefty swing against the coalition, should Howard be focusing on the most marginal of seats or should he let seats like Braddon fall where they may and worry about hanging onto the ones where there are a few percentage points in it? The Government’s situation (and behaviour) seems so desperate, it would seem that hanging onto a bare majority of seats would be a reasonable target at this point.

I’ve been out walking the world a bit these past few days, and haven’t had a chance to say my piece about the Commonwealth hospital takeover beyond a brief snark. Others have now said many of the things I would say, so this is a bit of a “me too” entry (not that I condone metooism, Kevin).